The role that mental health practitioners play in safeguarding wellbeing cannot be overstated. Employing approaches and techniques whose effectiveness has been proven, these practitioners lead clients in their quest for healing. However, if the practitioner is to be successful in delivering treatment, they need to adopt interventions that are grounded in sound research and account for the dynamics of individual patients. It is particularly important for practitioners to seek to establish positive relationships with their clients. These relationships are critical because they enable the practitioner to gain trust and create an environment of openness. Thanks to a recent engagement that I had with a client, I have developed a deeper understanding of the vital role that mental health professionals play. Through the interaction with this client, I have particularly been able to recognize the need for competence, experience and client-focused interventions.
The Treatment Process
Description of Unfolding Process
The client with whom I interacted was a 33 year old Hispanic who sought help for an alcohol and substance abuse problem. This client represents a growing problem that afflicts millions in the United States. According to the Swendsen et al. (2012), alcohol and substance abuse are highly prevalent in the country, particularly among adolescents. During the initial phases of the treatment process, there were some challenges that threatened to frustrate healing. Among these challenges is limited experience and competence. For practitioners to effectively engage with their clients, they require competence which is usually gained through years of practice and training (Rush et al., 2013). Lacking the experience, I found it rather difficult to understand the anguish that the client had experienced and responding appropriately. While the challenges proved daunting, they had no adverse impacts on the client. As the client opened up about the abuse that he had suffered as a child at the hands of his father, we were able to create a climate of trust and friendship. He shared that his father was physically abusive and separated him from his mother. This separation and the pain that the father inflicted through physical abuse must have triggered the client’s alcohol and substance abuse. During our session, the client remembered how the abuse brought him pain and damaged his sense of self-worth. It is unfortunate that the case of this client is not isolated. Across the US, thousands of abuse and neglected children are left with wounds that take years to heal (Saunders & Adams, 2014). It is indeed important for concerned stakeholders to take all necessary steps to insulate children against all forms of abuse.
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The interaction with my client extended beyond the discussion of his past. After determining that his alcohol and substance abuse had damaged his relationships, cost him his job and pushed him to depression, we agreed that he needed to make some changes. For example, the client admitted that he understood that he could not stay on the path of destruction. Thanks to the validation that I offered coupled with his open discussion about his part, we reached the understanding that he needed to take charge of his life. I challenged him to strive to limit the influence of his past painful experiences on his life. To conclude the session, I urged him to remain strong and assured him that with continued commitment on his part, we would make remarkable progress. I regret failing to tell him that during future sessions, we would explore his past experiences further as we search for a lasting solution.
Alignment with Model
It is common practice for mental health professionals to base the interventions that they adopt and the manner of interactions with their clients on established theoretical model. For my engagement with the client, I chose to use various models. They include the psychodynamic, and solution focused. Essentially, the psychodynamic model is concerned with engaging in deep discussions with a client with the goal of unearthing the underlying roots of the problems for which they have sought treatment (Cabaniss, 2016). When they adopt this approach, practitioners attempt to reveal the origins of their client’s condition. On the other hand, as the name suggests, the solution focused model concerns finding effective interventions that address the problems that the client presents with. I particularly adopted motivational interviewing. This model is a client-centered approach aimed at challenging the client to make behavior changes that inspire them to be motivated towards accomplishing the goals that they have set (Mandy & Heeyoung, 2014). On the whole, I find that the solutions and techniques that I employed are aligned with the two models. For example, through the psychodynamic model, I led the client in establishing that the abuse that he suffered when growing up could be to blame for his alcohol and substance abuse. I employed the motivational interviewing approach to help the client to understand that he held the key to resolving the challenges that he grappled with. He committed to strive to abandon alcohol and substance abuse and repair the relationships that had suffered serious damage.
While I found that the two models that I adopted were aligned properly with the client’s treatment process. However, I also observed that the two models had some limits. For example, the psychodynamic model’s main limitation is that it seemed rather contrived. Applying it felt like desperately finding an issue on which to place the blame for the challenges that the client had faced. While it is possible that the abuse set him on the path of addiction and depression, it is also likely that some other factor is responsible for his problem. The motivational interviewing model also had some shortcomings. Its primary limitation lay in the fact that I lacked the experience, competence and knowledge needed to properly implement it. For example, this model works best when the practitioner poses a question that provokes the client to reflect on their experiences and recognize the need for changes. I was unable to ask the right questions and was forced to explain to the client how my attempt related to the motivational interviewing model. I do not think that this model is flawed in itself. I simply lacked the experience and competence that I needed to implement it properly. Despite these limitations, I am confident that the two models were the most appropriate and that they helped to advance the treatment process.
In addition to the two models discussed above, I also adopted cognitive behavioral therapy (CBT). The primary goal of this model is to challenge clients to abandon unhelpful thoughts and behaviors and to guide them in making changes and adopting effective coping strategies. I incorporated this model because I felt that it was appropriate. The client’s thoughts and behaviors are unhealthy. For example, he believed that he had little value and that he had disappointed his family and partner. Additionally, to cope with the anguish and depression that he experienced, he turned to the very drugs and alcohol that were the cause of his problems. Despite my best efforts to explain CBT, I was unable to help the client benefit from this intervention. However, in future sessions, I intend to be more deliberate in my application of CBT so that it enhances the wellbeing of my clients.
Impact of Skills on Engagement with Client
As stated earlier, competence plays a crucial role in determining the success of the treatment process. It is indeed critical for practitioners to possess various skills. Empathy, genuineness and respect are some of the most important skills (Wills, 2012). During the session with my client, I effectively exhibited these skills. For example, I empathize deeply with him for the pain that he endured. I shared my sense of anguish and regret that he had been subjected to years of abuse. I found that by being empathetic, I basically encouraged the client to trust me and open up more about his struggles. Furthermore, empathy played the critical role of allowing me to use my own experiences to direct the treatment process. I also found genuineness to be a vital skill. Basically, this skill is concerned with honest, authentic and unfiltered communication and response to the issues that the client raised. There were moments where I felt that I was overly genuine and feared that this could adversely affect the treatment. For instance, I was visibly shocked when the client shared that his father dragged his sister by her hair. Fortunately, my authentic and unedited responses helped to move the session forward. The client trusted me and even admitted that he had not planned to reveal some of the details that he shared during the session. I would strongly encourage other practitioners to be genuine and authentic. As they do this, they help to put their clients at ease and create an environment of trust, warmth and comfort.
In addition to genuineness and empathy, respect also served a crucial role in my engagement with the client. Essentially, respect involves recognizing the value of the client and refraining from imposing ideas or perspectives on the client. As Frosch and Tai-Seale (2014) determined, when practitioners respect their patients, they gain respect and the clients hold them in high regard. I can confirm that respect is indeed vital for creating a healthy relationship with clients. I was able to persuade my client to reveal his abuse thanks mostly to the respect that I demonstrated. Instead of pushing the client in a particular direction, I allowed him to determine the pace and focus of our discussion. In essence, I placed him in charge of the treatment process. I did this because I believe that patient-focused and patient-driven treatment is far more effective than administering practitioner-dictated interventions.
Evolution of Treatment Relationship
The relationship between the client and the practitioner is indeed important. A healthy relationship defined by collaboration, respect and trust holds the key to effective treatment (Tasman & Mohr, 2011). I found that for the most part, the relationship between the client and me was healthy and productive. However, to establish this relationship, we had to invest effort and commitment. Initially, the relationship was characterized by tensions, suspicion and awkwardness. The client was reluctant to share intimate details of his experiences. However, due to the tremendous patience that I demonstrated, the relationship evolved to become one of openness and authentic interaction. I feel that the evolution of the relationship shed light on the client’s social identity as well as my own. Initially, I felt that the client’s identity had been shaped by his experiences. He regarded himself as a failure who had disappointed his family and caused irreparable damage to his relationship with his partner. As the session progressed, the client was eventually able to recognize his worth and understand that he could take initiative and reclaim his life. On the other hand, I felt that I offered stability and objectivity. By staying focused on the goals of the treatment, I was able to ensure that all our interactions facilitated the client’s recovery and healing. I find that the client’s and my own identities interacted seamlessly to yield a productive and fulfilling session. By serving as a stable hand, I helped the client to move away from his feelings of self-loathing to a position of immense confidence and tremendous positivity.
It is true that on the whole, the session with my client was satisfying and fueled progress. However, there are some blunders and failures that I feel hampered our interactions. Offered an opportunity to engage with the same client, there are some things that I would approach differently. These things include refraining from excessive displays of emotion, ensuring that my personal and biased perspectives do not creep into the session, and playing a more active role in issuing assurances and guiding the treatment process. I observed that my facial expressions were rather excessive and that they could threaten the client’s recovery. Additionally, I relied largely on my own experiences to inform how I interacted with the client. I think that when practitioners use their own experiences and perspectives, they risk tainting the treatment process with bias. It is important for practitioners to religiously use established protocols and interventions. I believe that by making these changes, I would be a far more effective practitioner who implements evidence-based solutions while remaining objective and fair.
Ethical and Social Justice Issues
Ethical and social justice issues are among the matters that mental health practitioners are being challenged to tackle in their work. During my discussion with my client, I observed that there were a number of these issues that emerged. Among the issues is the oppression and injustice endured by members of the LGBT community. The client identified as gay and although he did not claim that his sexuality had made him the subject of discrimination or injustice, I gathered that he may have been treated poorly owing to his sexuality. I am proud of being part of an agency that attends to all clients equally, regardless of their sexual orientation. Today, across the US, reports of members of the LGBT community being discriminated against are emerging. These reports underscore the need for the mental health community to be in the forefront of campaigning for the better treatment of the community. I challenge other providers and practitioners to emulate my agency and accept to offer the best possible care to patients without giving any regard to their sexuality. Another critical issue that was implicated in my work with the client regards the role that the family plays in influencing adult outcomes. I learnt that the alcohol and substance abuse problem that my client struggled with was the result of years of abuse. His experiences highlight the need for parents to ensure that the home environment is devoid of such issues as physical violence. More importantly, it is vital for families to provide support to members who are struggling with addictions. My client made progress thanks in part to the immense love and support that his family provided.
Evaluation of Effectiveness
The engagement with my client is one of the most fulfilling and insightful experiences that I have had. Thanks to this engagement, I gained a deeper and clearer understanding of the relationship between childhood experiences and adult outcomes. Furthermore, I was able to recognize the importance of validating clients and helping them to feel valued. Overall, I would rate my performance with this client as highly impressive. The main evidence for my excellent performance can be found in the outcomes of the session. As we parted ways, the client had achieved milestones. We established that the abuse was responsible for his alcohol and substance addiction and that he possesses tremendous value and worth. Furthermore, I successfully guided him to acknowledge that he is the only individual with the power to direct his life. He left the office more confident and assured. The expert application of theories and models serves as further evidence that I performed well. As mentioned earlier, I used the motivational interviewing and psychodynamic models to understand the client’s problems and develop effective solutions. While I encountered some challenges, I was able to resolve them and ensure that they posed no threat to the client’s journey toward recovery. I admit that there are some things that I could have done differently. For future interactions with clients, I will strive to be better prepared. For instance, I will ensure that I fully understand the models that I adopt.
In conclusion, there is no question that mental health practitioners serve an important function. By harnessing their experience, competence and training, they join forces with troubled clients to find solutions. I am able to confirm that these practitioners are vital for securing human wellbeing. Through my interaction with a 33 year old gay man who had struggled with alcohol and substance abuse, I gained first-hand insights into the dynamics of mental health practice. This client enabled me to better understand the need to match interventions and perspectives with the specific needs and challenges of individual clients. I achieved success because I adopted a client-focused approach through which I established a trust-based relationship. I would encourage my colleagues to endeavor to serve the best interest of their clients in all their professional pursuits.
References
Cabaniss, D. L. (2016). Psychodynamic psychotherapy: a clinical manual. Hoboken, NJ: Wiley.
Frosch, D. L., & Tai-Seale, M. (2014). R-E-S-P-E-C-T- what it means to patients. Journal of General Internal Medicine, 29 (3), 427-8.
Mandy, D., & Heeyoung, L. (2014). Motivational interviewing: a journey to improve health. Nursing2014, 44 (3), 40-45.
Rush, B., McPherson-Doe, C., Behrooz, R. C., & Cudmore, A. (2013). Exploring core competencies for mental health and addictions work within a Family Health Team setting. Mental Health in Family Medicine, 10 (2), 89-100.
Saunders, B. E., & Adams, Z. W. (2014). Epidemiology of traumatic experiences in childhood. Child and Adolescent Psychiatric Clinics of North America, 23 (2), 167-84.
Swendsen, J., Burnstein, M., Case, B., Conway, K. P., Dierker, L., Jianping, H., & Merikangas, K. R. (2012). Use and abuse of alcohol and illicit drugs in US adolescents . Results of the national comorbidity survey-adolescent supplement. JAMA Psychiatry, 69 (4),390-8.
Tasman, A., & Mohr, W. K. (2011). Fundamentals of psychiatry. Hoboken, NJ: Wiley.
Wills, F. (2012). Cognitive behavior therapy: foundations for practice. Thousand Oaks, CA: SAGE.
